NURS 6531 Week 4 Discussions 1 & 2 Latest

DQ1 – Blood Clots

Blood clots form in various locations of the body and are not unique to any specific age group or gender. While there are certain risk factors that may make a patient more likely to develop blood clots, essentially any patient is a potential candidate. Unfortunately, blood clots often go unrecognized until something happens.

Even if the patient identifies a problem and seeks medical care, blood clots are frequently misdiagnosed resulting in serious medical complications and sometimes death. Why does this happen? How can you, as the advanced practice nurse, protect your patients from misdiagnosis?

Consider the following case studies:

Case Study 1:

A 44-year-old African American male had a partial colectomy to have a cancerous tumor removed. The patient did really well after surgery and was discharged from post-op recovery to the surgical unit at a medical center. Approximately one hour after surgery, the patient complained of gas pains and shortness of breath. The patient continued to complain of gas pains after administration of morphine sulfate. Providers failed to diagnose a pulmonary embolism that resulted in the loss of the patient’s life.

Case Study 2:

A 50-year-old white male went to the emergency department with complaints of right leg pain. The patient is an avid runner, and knowing this, the provider diagnosed the patient with a right leg muscle strain. The patient was sent home with Flexeril as needed and Motrin 800 mg q8h as needed. One week later, the patient followed up with his primary care doctor with continued right leg pain.

His doctor instructed him to continue to take the muscle relaxant and Motrin, and advised that the pain should subside in 5–10 days. The following day the right leg pain increased, prompting the patient to return to the emergency department. Multiple providers failed to diagnose a blood clot in the patient’s right leg.

To prepare:

Review Part 11 of the Buttaro et al. text in this week’s Learning Resources.
Select one of the cased studies provided. Reflect on what went wrong in this case study, as well as why patient blood clots continue to be misdiagnosed.
Think about how you might have prevented the misdiagnosis of the patient the case study. Consider strategies for obtaining patient history, ordering diagnostics, and recommending potential treatment options.

Post on or before Day 3 a description of what went wrong in the case study that you selected, as well as why patient blood clots continue to be misdiagnosed. Then, explain how you might have prevented the misdiagnosis of the patient in the study. Include strategies for obtaining patient history, ordering diagnostics, and recommending potential treatment options.

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DQ2 – Types of Anemia

In clinical settings, patients often present with many different types of anemia. Each type of anemia has its own causes and implications. For this reason, you must be able to differentiate between types of anemia as well as identify factors that put patients at greater risk of experiencing related complications. As you prepare for this Discussion, consider the following patient case studies:

Case Study 1:

An 82-year-old female presents to the office complaining of fatigue, dizziness, weakness, and increasing dyspnea on exertion. She has a past medical history of atrial fibrillation, hypertension, and hyperlipidemia. Medications include warfarin 2 milligrams po daily, lisinopril 10 milligrams po daily, and simvastatin 10 milligrams po daily.

There are no known drug allergies. The physical exam reveals a 5’2” older female. Her weight is 128 pounds, blood pressure is 144/80, heart rate is 98, temperature is 98 degrees Fahrenheit, and O2 saturation is 98%. Further examination reveals the following:

Eyes: + pallor conjunctiva

Cardiac: irregular rhythm. No S3 S4 or M. NO JVD

Lungs: CTA w/o rales, wheezes, or rhonchi

Abdomen: soft, BS +, + epigastric tenderness. No organomegaly, rebound, or guarding

Rectal: no stool in rectal vault

Case Study 2:

A 28-year old female presents for a routine physical. She has no complaints. Her personal medical history reveals asthma that is well controlled with an albuterol inhaler prn and Advair 250/50 1 puff BID. Social history reveals she is a nursing student who is a non-smoker, rarely uses alcohol, and is mostly vegetarian. Her physical exam is negative, and she is sent for a CBC/differential and lipid profile. Laboratory results reveal the following: Hemoglobin 10, Hematocrit 30.1, MCV increased.

Case Study 3:

A 78-year-old female presents to the emergency room after a fall 3 days ago. She recently had a right above-the-knee amputation and was leaning over to pick something up when she fell. She did not want to come to the hospital, but she is having difficulty managing at home because of the pain in her left leg where she fell. Her patient medical history reveals RAKA, peripheral vascular disease, Type 2 diabetes, and stage 3 chronic kidney disease.

Current medications include quinapril 20 milligrams PO daily, Lantus 30 units at bedtime, and Humalog to scale before meals. There are no known drug allergies. The physical exam is negative and x-rays reveal no acute injuries. Laboratory studies reveal a normal white blood cell count: Hgb of 8 and HCT 24. The MCV is normal.

To prepare:

Review Chapter 213 in Part 18 of the Buttaro et al. text.
Select one of the three case studies. Reflect on the provided patient information including history, physical exams, and lab reports.
Think about a differential diagnosis. Consider the role the patient history, physical exam, and lab reports played in the diagnosis.
Reflect on the pathophysiology of the type of anemia that you diagnosed, as well as potential treatment options. Consider the causes of this type of anemia. Think about whether the patient should be referred for specialized care. NURS 6531 Week 4 Discussions 1 & 2 Latest

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Week 4 Assignment: Practicum Experience – Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your Practicum Experience. By applying the concepts that you study in the classroom to clinical settings, you enhance your professional competency.

Each week, you complete an Assignment such as Journal Entries and SOAP Notes that prompts you to reflect on your Practicum Experiences and relate them to the material presented in the classroom. This week, you begin documenting your Practicum Experiences in your Practicum Journal.

To prepare for this course’s Practicum Experience, address the following in your Practicum Journal:

Select and describe a nursing theory to guide your practice.
Develop goals and objectives for your Practicum Experience in this course. When developing your goals and objectives, be sure to keep the seven domains of practice in mind.
Create a timeline of practicum activities based on your practicum requirements.

By Day 7 of Week 4

This Assignment is due. You will submit this Week 1 Journal Entry, along with the Week 2 Journal Entry, the Week 3 SOAP Note, and Week 4 Journal Entry by Day 7 of Week 4. NURS 6531 Complete Weekly Assignments Latest

Assignment: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on pattern recognition in diagnoses. Explain how pattern recognition of patient symptoms might help lead to a diagnosis. If you have not yet been placed at a practicum site, please contact your Instructor.

By Day 7 of Week 4

This Assignment is due. You will submit this Week 2 Journal Entry, along with the Week 1 Journal Entry, the Week 3 SOAP Note, and Week 4 Journal Entry by Day 7 of Week 4.

Journal

In addition to Journal Entries, SOAP Note submissions are a way to reflect on your Practicum Experiences and connect these experiences to your classroom experience. SOAP Notes, such as the ones required in this course, are often used in clinical settings to document patient care. Please refer to the Seidel, et. al. book excerpt and the Gagan article located in this week’s Learning Resources for guidance on writing SOAP Notes.

After completing this week’s Practicum Experience, select a patient that you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

Subjective: What details did the patient provide regarding his or her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management including alternative therapies?

Reflection notes: What would you do differently in a similar patient evaluation?

By Day 7 of Week 4

This Assignment is due. You will submit this Week 3 SOAP Note along with your Journal Entries (Weeks 1, 2, and 4) by Day 7 of Week 4.

Assignment: Practicum Experience – Journal Entry

After completing this week’s Practicum Experience, reflect on a patient with a known history of a cardiovascular disorder such as a blood clot or arrhythmia. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care.

If you did not evaluate a patient with this background during the last four weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

By Day 7 of Week 4

This Assignment is due. You will submit this Week 4 Journal Entry along with the Week 1 and Week 2 Journal Entries, and the Week 3 SOAP Note by Day 7.

Note: Be sure to submit your Assignment to the appropriate submission link below.

Submissions should match the following:

Week 1 Theory for Practice: Submit to the Assignment Part 1 – Week 4 submission link.
Week 2 Pattern Recognition: Submit to the Assignment Part 2 – Week 4 submission link.
Week 3 SOAP Note: Submit to the Assignment Part 3 – Week 4 submission link.
Week 4 CV Disorder: Submit to the Assignment Part 4 – Week 4 submission link

The Journal Entries are assessed with a Satisfactory (S) or Unsatisfactory (U) score. This concept also applies to Weeks 7 and 10.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the following naming convention: “WK4PTXAssgn+lastname+first initial”.
Click the Week 4 Assignment Part X links.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4PTXAssgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.
Click on the Submit button to complete your submission.

NURS 6531 Week 4 Discussions 1 & 2 Latest